Healthcare Provider Details

I. General information

NPI: 1609706340
Provider Name (Legal Business Name): AVAD THERAPY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 BLUESTEM DR STE 9106
PROSPER TX
75078
US

IV. Provider business mailing address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

V. Phone/Fax

Practice location:
  • Phone: 347-204-6135
  • Fax: 347-204-6135
Mailing address:
  • Phone: 347-204-6135
  • Fax: 347-204-6135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIYANA M ZACHERY
Title or Position: LMFT, OWNER
Credential: ZACHERY
Phone: 404-488-6429